Correlation between Fibrinogen and White Matter Hyperintensities among Nondiabetic Individuals with Noncardiogenic Ischemic Stroke

The aim of the present study is to confirm the correlation between fibrinogen and the severity of cerebral white matter hyperintensities (WMHs) among nondiabetic patients with noncardiogenic acute ischemic stroke.A cross-sectional study of 170 consecutive patients with noncardiogenic acute ischemic stroke who underwent magnetic resonance imaging and vascular imaging was conducted. WMHs were classified into periventricular hyperintensity (PVH) and deep and subcortical WMH (DSWMH) using Fazekas rating scale. After adjustment for fibrinogen and other vascular risk factors, we determined which factors were independent of WMHs.After adjustment for the vascular risk factors, prior ischemic stroke (odds ratio [OR] 4.153, 95% confidence interval [CI] 1.077-16.020, P = .039), fibrinogen level (OR 2.114, 95% CI 1.034-4.322, P = .040), and glycosylated hemoglobin A1c (OR .633, 95% CI .423-.947, P = .026) were independently and positively associated with PVH (P .05); prior ischemic stroke (OR 2.841, 95% CI 1.469-5.493, P = .002), lipoprotein(a) (OR 1.002, 95% CI 1.000-1.005, P = .047), and fibrinogen levels (OR 1.788, 95% CI 1.170-2.732, P = .007) were independently and positively associated with DSWMH (P .05).Our study demonstrated that prior ischemic stroke and higher fibrinogen are associated with WMHs, regardless of PVH and DSWMH, in nondiabetic patients with noncardiogenic acute ischemic stroke. In addition, lipoprotein(a) might be an independent predictor of DSWMH in patients with noncardiogenic acute ischemic stroke.